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Regulatory Capture in Healthcare

Healthcare reform is stuck in the red herring issue of providing access to healthcare to more people, which is desirable indeed, but it is a complete distraction from the fact that healthcare itself is a complete failure. By the numbers, we have the most expensive healthcare system at twice the cost of most of the industrialized world, achieving however 37th place in the world in terms of actual health outcomes. At a cost of nearly 20% of GDP, we are achieving 3rd world outcomes. That is the macro-economic viewpoint, at the micro-economic level, the so-called heathcare system only works to lull asleep the people who don’t need healthcare into thinking they have healthcare and ignore the fact that many of the people who do have health crises soon find out that they can’t afford to be sick.

Famously, Congresswoman Alexandria Ocasio-Cortez (AOC for short) declared that, as a congresswoman, she now has healthcare after not having any for some time. The truth is our ‘healthcare’ system has her, not the other way around. The sad fact is that she merely acquired a pile of chips in the casino that maximizes profits by maximizing treatments for as many diseases as it can possibly come up with, where the realistic outcome is that more people lose than win, and the biggest losers end up filing medical bankruptcies when they have real healthcare crises. We have profit-maximizing sick care system that is ruled by the principle that more medical interventions mean more money, and maintaining illness is more profitable than healing patients. If these moral hazards are not dealt with, healthcare reform will remain elusive.

.@RepAOC@AOC on health care: “I was uninsured 7 months ago…It’s not just a financial issue. It is the stress…everything becomes a spiral anxiety because you don’t know how you’re going to afford it…I rationed my own health care for 10 years…We are rationing our own care.” pic.twitter.com/sm9dXv9lkm

The problem is my favorite Congresswoman has now become a shill for the for-profit system that is designed on the back of the completely obsolete monopoly of the AMA and allopathy on medicine, which has long been overtaken by changes in our healthcare needs. What is considered “medicine” is in practice limited to allopathic treatments by MD’s and their staff and any other healing modalities are basically shunned if not actively combated as quackery. It pays to recall is that the AMA was established under the glow of successes with infectious disease, and with the purpose of limiting competition and to keep women, blacks and poor people out of medicine (if in doubt, see Rockefeller’s Medicine Men). The single, most overt way that this evidently does not work is in the area of the chronic, degenerative, systemic illnesses that account for 7 out of 10 deaths today and for about 86% of total healthcare expenditure. These are all diseases of affluence that we now know can be largely prevented or reversed with a Whole Foods, Plant-Based diet.

The list includes cardiovascular disease (CVD), Hypertension, Diabetes (mostly T2D, for 95% of cases, and to a lesser degree T1D), Rheumatoid Arthritis (RA), Multiple Sclerosis (MS), Asthma, Irritable Bowel Syndrome (IBD), Crohns disease, Lupus and other auto immune diseases, Alzheimers, all of which can be largely or partially prevented or reversed with a Whole Foods, Plant-Based diet, whereas medical interventions usually are merely palliatives, that allow unchecked progression of these diseases and escalating treatments. The prognoses usually start with: “You’ll have to take these pills for the rest of your life,” which to a large degree means that medical intervention was the wrong place to look. Dr. Dean Ornish speaks of the unified theory of disease these days (see his book Undo it!), which is that lifestyle issues, and largely diet are the common cause of all these illnesses, and that lifestyle changes, starting with a whole foods, plant-based diet can turn them around.

Lifestyle Medicine is the new form of primary care practice that is now emerging, which in effect opens the aperture of diagnosis and treatment to include plant-based nutrition. While in acute cases medical intervention may be needed, in a great many cases little or no medical intervention may be required, only the adoption of a Whole Foods, Plant-Based diet and other lifestyle changes involving sleep hygiene, exercise, relationships and relaxation. Doctors are adopting this new modality in growing numbers, because for them it means restoring the professionalism and meaning of their profession, as they increasingly feel that pharmageddon has usurped their purpose of healing. Working with their patients in a more in-depth way towards achieving health is much more satisfying for them, unless they belong to the class that the pharmaceutical industry lovingly calls “drug whores.”

How Corruption Works

The power of corruption lies in the fact that it always starts so innocuous. In this case, the congresswoman is bamboozled into thinking she has ‘healthcare,’ and never quite realizes it is not working for the people who need it most, and it is not working for society at large. She has been comped a stack of chips in the healthcare casino and thereby remains ignorant of her own responsibility for her health. Meanwhile, USDA and HHS have historically always protected the food industry over the health of consumers, and it will be interesting to see if the 5-year revision due in 2020 will continue that tradition or finally tune in to the science of nutrition and health.

In short our healthcare system is a casino where you are comped a certain amount of chips through employer funded healthcare programs that allow you to ignore the progression of illnesses preferably until retirement, at which point the damage is often irreversible, and you are going to be less able to afford the medical system that has trained you all your life that this is your only option. Even more ridicously, this system is not working for doctors either. Burnout is a common problem for physicians, and the ones that have turned to Lifestyle Medicine are so grateful they can finally practice medicine as it was meant to be: helping their patients heal and stay healthy, on occasion supporting the process with medical intervention, if it is required.

In the healthcare casino, you cannot win. You get lured in by comping you some chips, some drinks and maybe even a room while you are healthy, in the form of our employer based healthcare system, creating the moral hazard that you do not take care of your health, because you think others are going to pay for it if it fails you. This moral hazard is exacerbated exactly because the system itself removes responsibility for your health from you to the healthcare system, it is the expropriation of health, as Ivan Illich called it. Evidently, the government is promoting ill health by means of its dietary recommendations, so it creates a steady stream of customers for the healthcare system. Like Congresswoman AOC the users of the system are utterly clueless of the scam they are caught up in. Yet it begins so simply: doctors are not even taught nutrition in medical school, so they ignore the possibility of changes in diet and lifestyle, let alone that these could be more powerful than any amount of medical intervention.

How to Escape Medical Corruption, Regulatory Capture and Moral Hazard

First of all, we have to stop long enough to realize that the existing system does not work, and since 86% of healthcare dollars are misspent on maintaining disease instead of healing patients, this is where the real healthcare reform must begin. It is already beginning by the proliferation of Lifestyle Medicine and to a degree it is welcomed by the insurance industry, for it is evidently more economical to spend mere thousands on programs to teach people healthy lifestyles, compared to the lifetime costs of diseases like heart disease or diabetes that can easily run into the millions and will more than likely bankrupt the patients, in spite of the healthcare system. The two leading causes of death are diet and doctors. Let the real healthcare reform begin.

Real healthcare reform will have to accomplish a complete change of the healthcare paradigm, beginning by returning to the Hippocratic saying to let food be thy medicine. Personal responsibility and accountability will have to play a central role in these reforms, to reduce the moral hazard with its endemic corruption that has led to regulatory capture on a lot of levels.